| NPI | 1053796383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006106) |
| 363A00000X Physician Assistant (Licence: CA 52683) | |
| 363A00000X Physician Assistant (Licence: AZ 9262) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2025-01-23 |